Mr Wallace Edward Brandies Jr, CSAC ICS - Counselor in Racine, WI

Mr Wallace Edward Brandies Jr, CSAC ICS is a Counselor - Addiction (substance Use Disorder) based in Racine, Wisconsin. Mr Wallace Edward Brandies Jr is licensed to practice in Wisconsin (license number 15295-132) and his current practice location is 1717 Taylor Ave, Racine, Wisconsin. He can be reached at his office (for appointments etc.) via phone at (262) 638-6635.

NPI number for Mr Wallace Edward Brandies Jr is 1811595671 and his current mailing address is 1717 Taylor Ave, Racine, Wisconsin. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1811595671.

Contact Information

Mr Wallace Edward Brandies Jr, CSAC ICS
1717 Taylor Ave,
Racine, WI 53403-2405
(262) 638-6635
(262) 638-6540

Map and Direction


Healthcare Provider's Profile

Full NameMr Wallace Edward Brandies Jr
GenderMale
SpecialityCounselor - Addiction (substance Use Disorder)
Location1717 Taylor Ave, Racine, Wisconsin
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1811595671
  • Provider Enumeration Date: 10/14/2020
  • Last Update Date: 10/14/2020

Medical Identifiers

Medical identifiers for Mr Wallace Edward Brandies Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1811595671NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YA0400XCounselor - Addiction (substance Use Disorder) 15295-132 (Wisconsin)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Wallace Edward Brandies Jr is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Wallace Edward Brandies Jr, CSAC ICS
1717 Taylor Ave,
Racine, WI 53403-2405

Ph: (262) 638-6635
Mr Wallace Edward Brandies Jr, CSAC ICS
1717 Taylor Ave,
Racine, WI 53403-2405

Ph: (262) 638-6635

Reviews and Comments


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